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A 73-year-old man presented with lymphadenopathy, hepatosplenomegaly, and a variety of hematological and immunological abnormalities.

Combination of these observations indicated that the underlying disorder of this patient was angioimmunoblastic T-cell lymphoma (AITL); postmortem pathology was consistent with progression of peripheral T-cell lymphoma.

Even in the absence of definitive lymph node biopsy, the appearance of the bone marrow and the peripheral blood can lead to the diagnosis of AITL.

Despite the presence of pleural effusion, the diagnosis of mesothelioma was initially established by cytologic ex-amination of pericardial fluid, due to the patient's critical cardiac condition requiring prompt subxiphoid pericardiocentesis.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

We investigated the potential utility of touch imprints evaluated in conjunction with the histology of lymph nodes in the diagnosis of AITL.

CASE A 58-year-old man presented with generalized lymphadenopathy, splenomegaly, and autoimmune phenomena, which complicated the diagnosis.

Touch imprints were obtained from the lymph node biopsy, which were valuable in making the correct diagnosis.

The cytologic and microscopic features of these imprints and lymph node samples showed a heterogeneous population of hematolymphoid cells, including small to intermediate lymphoid cells, immunoblasts, plasma cells, dendritic cells, and eosinophils, as well as small vessels that were surrounded by some of the abnormal cells.

CONCLUSION: We draw attention to this neoplastic diagnosis and correlate the cytomorphologic and immunohistochemical findings with the adequate clinical setting in order to avoid misdiagnosis, primarily with Hodgkin's lymphoma and reactive hyperplasia.

Touch imprints are useful in the diagnosis of AITL if the broad population of proliferating cells is distinguished.

However, some cases display binucleated or mononucleated cells with prominent nucleoli and many eosinophils, which may induce a potential misdiagnosis with Hodgkin's lymphoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Diffuse large B-cell lymphoma in patient after treatment of angioimmunoblastic T-cell lymphoma.

Relatively few cases of Epstein-Barr (EBV)-positive B-cell lymphomas arising in patients with angioimmunoblastic T-cell lymphoma (AITL) have been reported.

We report a case of AITL in which diffuse large B-cell lymphoma arose 13 months after the initial diagnosis of AITL.

In a 36-year-old female patient, evaluated for moderate leukocytosis, peripheral and abdominal lymphadenopathy AITL was diagnosed in March 2008, based on results of fine-needle aspiration cytology (FNAC) of the enlarged cervical and supraclavicular lymph nodes.

The diagnosis was also confirmed by immunophenotyping and histopathology of the cervical lymph nodes.

In April 2009 the patient was hospitalized because of fever, pancytopenia, hyperbilirubinemia and peripheral lymphadenopathy.

The FNAC of the enlarged cervical lymph nodes was performed again, but this time the smears were composed of polymorphous population of lymphocytes with the predomination of large cells, CD20+ on immunocytochemical stains.

AITL is a rare lymphoproliferative disorder in which the neoplastic T-cells represent the minority of the lymph node cell population and almost all cases harbor EBV-infected B-cells.

Various authors postulated that immunodeficiency in AITL patients together with immunosuppressive effects of cytotoxic drugs, may be responsible for EBV-induced proliferation of latently or newly EBV-infected B-cells with eventual clonal selection and progression to aggressive B-cell lymphoma.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

In most cases of lymphomas with blood dissemination, the careful cytological analysis of peripheral blood smears provides a rapid orientation to diagnosis, even if the final subtyping is achieved by histology and eventually other techniques.

Here, we evaluated if the analysis of blood smears may suggest the blood dissemination of angioimmunoblastic T-cell lymphoma (AITL) and if CD10 expression on neoplastic T cells, as recently reported on AITL, may contribute to the diagnosis.

In all, 11 lymph nodes and six peripheral blood samples from 12 patients with AITL were studied using four-colour flow cytometry associated to histological, cytological and molecular data.

According to previous results, a fraction of T cells expressed CD10 in 10/11 lymph nodes.

Interestingly, all blood smears showed atypical lymphoid cells and a fraction of T cells expressed CD10 with a mean percentage of 18.75% (range 5.00-47.00%), regardless of lymphocytosis level and of rate of CD10 T cells in corresponding lymph node.

In contrast, in all control samples (100), none CD10-positive T cell was identified.

Therefore, they ought to be explored in further studies when aggressive lymphoma, in particular with lymphopenia and circulating atypical cells, is suspected.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Frequent occurrence of B-cell lymphomas in angioimmunoblastic T-cell lymphoma and proliferation of Epstein-Barr virus-infected cells in early cases.

Secondary lymphomas occurring in the setting of angioimmunoblastic T-cell lymphoma (AILT) are considered to be rare.

The present study aimed at estimating the frequency of B-cell lymphomas in AILT.

By studying the expression of EBV and activation-induced cytidine deaminase (AID) as an indicator of hypermutating cells, we assessed whether B-cell lymphoproliferations in AILT were strictly associated with EBV and whether hypermutation might contribute to lymphomagenesis.

Among 161 cases of AILT, diagnosed between 1996 and 2005 at the lymph node registry, Frankfurt, Germany, 19 cases were detected that also had B-cell non-Hodgkin lymphoma (NHL) and two cases had classical Hodgkin lymphoma (HL).

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

To evaluate the clinical, pathological characters and prognosis of patients with angioimmunoblastic T cell lymphoma (AITL), the clinicopathologic features, immunophenotypes, therapy and survival rate of 12 AITL patients which were confirmed by pathologic examination were retrospectively studied.

The results indicated that main symptom was observed as general lymphadenopathy, however, 9 patients had fever.

The diagnosis of AITL was based on lymph-node biopsy.

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The lymph node lesion was accompanied by large blastic B cells with an association of Epstein-Barr virus.

Phenotypical examination of the lymph node also revealed the predominance of CD4+ T cells in addition to the proliferation of follicular dendritic cells, but no light chain restriction in large B cell components.

Based on the combined data described here, our preferred diagnosis was angioimmunoblastic T cell lymphoma with Epstein-Barr virus-associated B cell lymphoproliferative disorder, the pathogenesis of which was suggested to be closely associated with immunosuppressive treatment for progressive systemic sclerosis.

One PTCL-NOS case strongly expressed FoxP3 in the neoplastic T cells and showed unusual histomorphologic features with a dense infiltration of the lymph node by immunoblastic T cells and almost no reactive background infiltrate.

The patient died shortly after diagnosis, suggesting that biologic properties of Treg cells may have contributed to the rapidly fatal clinical course.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

Peripheral T-cell lymphoma (PTCL) with a nodular architecture is rare.

Recently, two variants have been described with infiltration of the B-cell follicle, one variant that localizes to the marginal zone with a so-called perifollicular growth pattern, and a variant that localizes to the germinal center.

We have studied five similar cases of PTCL with involvement of the B-cell follicle.

However, our cases differ from the cases previously described by their predominant and frequently patchy involvement of the expanded mantle zone of the B-cell follicle at onset.

Later biopsies in three of the cases show diffuse infiltration of the lymph node, without features of angioimmunoblastic TCL (AILT).

Whether our cases are part of a spectrum of PTCLs that encompasses previously described variants with predominant marginal zone or germinal center infiltration or they represent a separate T-cell lymphoma type remains to be demonstrated by a study of more of such cases.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] 'Normal counterparts' of nodal peripheral T-cell lymphoma.

Peripheral T-cell lymphomas (PTCL) have been difficult to classify.

A homogeneous principle of classification is still lacking, partly because lymph node compartments containing functionally distinct T-cell subsets have not been identified.

A correlation to differentiated T-cell subsets, as CD4(+) or CD8(+) cells as well as cytotoxic populations has not revealed clinically meaningful entities.

Immunohistological analysis of PTCL showed an effector or effector-memory cell phenotype (CD45RA(-)/CD45R0(+)/CD27(-)) for both angioimmunoblastic T-cell lymphoma (AILT) and anaplastic large cell lymphoma (ALCL), but different cytotoxic and activation markers expressed by these tumours.

Clinically, they were characterized by systemic lymphadenopathy, "B"symptoms, polyclonal hypergammaglobulinemia, elevated serum lactate dehydrogenase and a transient presence of various autoantibodies, as well as an infrequent presence of atypical lymphocytosis in peripheral blood.

Although EBVAID appears to be rare in middle-aged and older adults, EBVAID exhibits histological variations and should be added to the differential diagnosis of various atypical or malignant lymphoproliferative disorders, in particular autoimmune-disease-associated lymphadenopathy and angioimmunoblastic T-cell lymphoma with a hyperplastic germinal center in middle-aged and elderly patients.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Cytogenetic study on 155 cases of non-Hodgkin' s lymphoma].

OBJECTIVE: To investigate the relationship between histopathological subtype of non-Hodgkin' s lymphoma(NHL) and chromosomal abnormalities, and compare the difference of chromosomal abnormalities between China and the West.

In reactive lymph nodes and tonsils, CXCL13 protein is mainly expressed by a subset of FDCs in B-cell follicles.

FDC-S are commonly associated with a dense intratumoural inflammatory infiltrate and immunohistochemistry showed that these lymphocytes express the CXCL13 receptor CXCR5 and are mainly of mantle zone B-cell derivation (IgD+ and TCL1+).

In addition to the potential biological relevance of this expression, the use of reagents directed against CXCL13 can be useful to properly identify the origin of spindle cell and epithelioid neoplasms.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Paraneoplastic lymphadenopathy].

MATERIAL AND METHODS: In a retrospective analysis of 457 patients observed in Hematology Research Center of the RF in 1994-2004, and diagnosed as having non-malignant lymphadenopathies, we identified 40 patients in whom the second or third biopsy showed lymphoma.

In paraneoplastic lymph nodes there were 3 cases of sinus histiocytosis, 1--necrosis.

In two of them the presence of malignancy was clinically evident at the moment of the first biopsy, while three had a long history of lymphadenopathy (time to diagnostic biopsies were 5, 13 and 34 months).

CONCLUSION: Histologic patterns in lymph nodes not involved by lymphomas in patients with lymphomas are not random.

We believe that paraneoplastic changes in lymph nodes are caused by partial tumor involvement, cytokine reaction, or antitumor immune response.

From practical point of view, finding of necrosis, prominent sinus histiocytosis, or prominent fibrosis of a lymph node in the absence of a history of chronic lymphadenitis or inflammation in the draining area should be considered as possible indication to second biopsy.

Interpretation of such paraneoplastic phenomena as paracortical hyperplasia and formation of epithelioid-cell granulemas is not easy and must consider context of a clinical picture.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

The human lymph node is a complex tissue resulting from the microenvironmental organisation of different cell populations linked by topographical and/or functional relationships.

On the whole, GC exerts a role in B cell physiology and malignancy.

Immunohistological analyses in lymphoma biopsy samples have confirmed that the biological behaviour and tumour progression may be influenced by the tumour microenvironment.

This review will examine GC-derived lymphomas, including follicular lymphomas, Hodgkin lymphomas and angioimmunoblastic T-cell lymphoma, through their integrated cellular microenvironment, highlighting those findings which may serve as a useful surrogate marker for tumour diagnosis or tumour progression, together with key molecules involved in tumour development.

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

OBJECTIVE: Membranous (M) cell of the human palatine tonsil is an antigen entry site for mucosal infection, but its location is obscure in histological sections.

Recently, a microarray analysis has demonstrated that clusterin, annexin A5, CD44, MMP14, and beta-tubulin are candidate genes of M cell marker in mice.

Among these genes, we here describe class II beta-tubulin as a new marker for human tonsillar M cells and follicular dendritic cells (FDCs), and present its usefulness for diagnosisof angioimmunoblastic T-cell lymphomas (AILTs).

MATERIALS AND METHODS: Immunohistochemistry and Western blotting for class II beta-tubulin were performed using 81 cases of lymphoid, gastrointestinal and thyroid tissues, and an FDC cell line, respectively.